Objective To explore the characteristics and drug resistance of pulmonary tuberculosis combined with Stenotrophomonas maltophilia infection.Methods The clinical data of 65 patients with Stenotrophomonas maltophilia infection were analyzed retrospectively.Results It showed that 65 strains of Stenotrophomonas maltophilia mainly came from sputum sample [75.4％(49/65)] and were highly resistant to many kinds of antimicrobial agents,of which the resistance rate to carbapenems,β-lactames was above 60％ and the sensitive rate to moxifloxacin,ethoprin-sulfamethoxazole and ticarcillin/clavulanic was above 70％.Conclusion Clinical practices should pay more attention to the high resistance of Stenotrophomonas maltophilia infection,which might result in pulmonary tuberculosis,and prescribe antibiotics rationally according to the drug sensitive test.

Objective To study the aplication effect of fiber bronchoscope examination in the treatment of respiratory internal medicine emergency and its effect on the quality of life of patients.Methods 156 patients with emergency were randomly divided into the observation group and control group,each group in 78 cases.The control group was given routine treatment plan according to the primary disease type which was the respiratory treatment of the corresponding diseases,the observation group in the control group was added fiberoptic bronchoscopy based on the treatment.Compared blood clinical curative effect,heart rate and quality of life score changes of the two groups of patients after treatment.Results The total effective rate of the observation group was 94.87%,which was significantly higher than 81.01% of the control group(χ2 =6.28,P <0.05).The pH,PaO2 and SaO2 in the observation group after treatment were(7.35 ±0.04),(73.23 ±9.11)mmHg and(92.33 ±4.32)%,which were significantly higher than the corresponding index in the control group(t =3.97,6.08,4.96,all P <0.05);while PaCO2 and HR were (51.53 ±9.24)mmHg,(91.69 ±12.42)times/min,which were significantly lower than the corresponding index in the control group(t =6.73,5.13,all P <0.05);The quality of life score in the observation group was(54.04 ± 10.94)points,which was significantly lower than(77.23 ±12.32)points of the control group(t =5.86,P <0.05). Conclusion Fiberoptic bronchoscopy for respiratory internal medicine emergency treatment can significantly improve the clinical curative effect of treating disease and patient quality of life.

Objective To explore the clinical value of the insulin pump(CSⅡ) and multiple subcutaneous insulin intensive treat-ment(MDI) for patients with type 2 diabetes and stroke .Methods A total of 80 patients with type 2 diabetes and stroke in Weifang Community Health Service Center from April 2011 to May 2014 were selected as subjects and divided into experimental group and control group according to random number table method ,with 40 cases in each group .Patients in the experimental group were trea-ted with CSⅡ ,patients in the control group were treated with MDI .Glucose level ,therapeutic time ,the number of low blood sugar , insulin dosage ,National Institute of Health Stroke Scale(NIHSS) score ,insulin secretion index(IS) ,insulin resistance index(IR) , hospital costs were compared before and after treatment in the two groups .Results The glucose levels ,therapeutic time ,the num-ber of low blood sugar ,insulin dosage ,NIHSS score ,IS ,IR in the two groups before and after breakfast ,before and after lunch ,be-fore dinner ,after dinner 2 hours before treatment had no significant differences(P>0 .05) ,the glucose levels ,therapeutic time ,the number of low blood sugar ,insulin dosage ,NIHSS score ,IS ,IR after treatment in both groups were significantly decreased at these time points ,but those indicators in the experimental group decreased more significantly ,and had significant differences with those of the control group(P<0 .05) .The cost of hospitalization of patients in the experimental group was significant lower than that in the control group(P<0 .05) .Conclusion CSⅡ treatment for type 2 diabetes and stroke patients ,not only control glucose level well ,re-duce the number of low blood glucose and insulin dosage ,significantly improved IS and IR ,reduce hospital costs ,and also could sig-nificantly improve the neurological disorders of consciousness ,which is an ideal treatment method compared with MDI .

Objective To study the expression of connective tissue growth factor(CTGF) and PEST containing nuclear pro‐tein(PCNP) and their significance in pancreatic cancer .Methods The expressions of CTGF and PCNP proteins were tested by im‐munohistochemistry and Immunofluorescence in 39 cases of pancreatic carcinomas and adjacent paracancerous tissues .Results The positive rate of CTGF and PCNP in pancreatic carcinomas was significantly higher than adjacent paracancerous tissues(χ2 =60 .41 , 51 .46 ,all P<0 .01) .The differences of the expression of CTGF and PCNP in pancreatic carcinoma of tumor differentiation ,TNM stage and lymph node metastasis was significant (P< 0 .05) .Conclusion The expression of CTGF and PCNP in the pancreatic cancer was obviously increased ,and the level of CTGF ,PCNP had remarkable connection with the stages of tumor and the condition of lymph node metastasis .

According to clinical epidemiological researches, the usage of antibiotics in infant increases the risk of childhood asthma morbidity. The mechanism of this link is not entirely clariifed, and it is assumed of being related to side effects of antibiotics, which changes the colonization of normal intestinal lfora and reduces the diversity. It is clear that normal intestinal lfora of infant help to construct innate immune system and adaptive immune system, and forge immune tolerance. Therefore, normal intestinal lfora might be helpful in reducing allergies. The usage of antibiotics in early life changes the quantity and the composition of intestinal lfora, and breaks the balance of immune homeostasis, which might increase the risk of asthma morbidity. The abuse of antibiotics in children is a general phenomenon in China which needs attention from pediatricians.

With the great success of imatinib mesylate(IM) and other tyrosine kinase inhibitor (TKI),chronic myelogenous leukemia (CML) is taken as a successful model of targeted therapies for human cancer.Although the emergence of TKI has greatly improved the prognosis of CML,the long-term TKI treatment may bring the problems of drug resistance,serious side effects,poor compliance,and heavy economic burden.Recently,people focus on whether patients would be cured after discontinuation of TKI treatment.Here,the progresses on discontinuation of TKI therapy in CML presented in the 54th American Society of Hematology (ASH) annual meeting were reviewed.

This article analyses and describes the influencing mechanism of hospital alliance on quality of care from six aspects:product and technology,organizational structure,psychosocial climate, management,organizational culture,and competition in medical service market.In order to ensure and improve the medical quality,this study discusses that hospital alliance can not only ally in the form but also optimize the internal structure,strengthen the integration of organizational culture of the institutions, gradually form a social psychological climate of“Quality First”.In addition,the government′s regulation on the medical service market is also indispensable.

Objective To compare the curative effect of several surgical treatments for closed urethral injury.Methods A retrospective study was done on 200 cases of closed urethral injury treated with various methods from June 2002 to June 2012,including 44 cases of anterior urethral injury treated with endoscopic transurethral realignment (anterior endoscopic group),32 cases of anterior urethral injury with transperineal urethral repair (repair group),42 cases of posterior urethral injury with transperineal urethral termino-terminal anastomosis (anastomosis group),35 cases of posterior urethral injury with endoscopic transurethral realignment (posterior endoscopic group),and 47 cases of posterior urethral injury with endoscopic transurethral and transvesical realignment (combined endoscopic group).Amount of bleeding,operation time,hospital stay as well as expense,and rate of urethral stricture and erectile dysfunction (ED) in treatment of anterior and posterior urethral injury were compared respectively.Curativeeffect and merits and faults of each treatment were observed.Results Anterior endoscopic group achieved less bleeding [(10 ± 5) ml∶ (100 ± 20) ml,P ＜ 0.05],shorter operation time and hospital stay [(15 ± 6) min∶ (40 ± 15) min,(14.2 ± 1.8) min∶ (28.5 ± 1.5) min respectively,P ＜ 0.05],lower hospital expense and urethral stricture rate[(4 715.42 ± 225.43) RMB∶ (6 886.46 ± 246.78) RMB,39％ ∶ 63％ respectively,P ＜ 0.05] as compared with repair group,but there was no statistical difference in ED rate between the two groups.Whereas in anastomosis group,the most bleeding [(200 ± 30) ml],longest operation time [(60 ± 20) minutes] and hospital stay [(28.7 ± 2.3) days],and highest hospital expense [(6 964.27 ± 275.69) RMB] and urethral stricture rate (95 ％) were detected (P ＜ 0.05).Posterior endoscopic group presented less bleeding [(15 ± 6) ml∶ (50 ± 12) ml,P ＜ 0.05] and shorter operation time [(21.4 ± 1.7) min∶ (21.2 ± 1.5) min,P ＜ 0.05] as compared with combined endoscopic group,but there were no statistical differences in hospital stay as well as expense and urethral stricture rate between the two groups.Moreover,ED rate was not statistically different among anastomosis group,posterior endoscopic group and combined endoscopic group.Conclusions Endoscopic surgery is superior to traditional surgery in terms of blood loss,operation time,hospital stay,and hospital cost.Besides,urethral stricture and ED rates are closely related to the location and severity of injury.

Objective: To compare utility values measured by different instruments. Methods: Different instruments were used to measure utility values in 350 patients who were diagnosed as age-related macular degeneration at the same time. The median of utility values measured by different instruments was regarded as relative standard utility value to process comparison, analysis of variance, correlation analysis and curve estimation. Results: Most differences and correlations among utility values measured by different instruments were significant, as well as equations estimated from relative standard utility value and utility values measured by different instruments, but the degree of fitting was not high. Conclusion: The utility values of the same subject measured by different instruments are quite different. The results of the study could provide correction reference to the utility value measured by single instrument in the absence of absolute standard.

MiRNA is a small non-coding single stranded RNA(ssRNA)which is made up by 21~23 nucleotide.This ssRNA has a double effect as tumor suppressor genes and oncogenes , and plays an important role in cell proliferation , differentiation and apop-tosis.Pancreatic carcinoma is a highly malignant tumor with poor prognosis and high mortality rate , and the early diagnosis is difficult . In the last decades , growing studies highlighted the interactions between miRNAs and pancreatic carcinoma .This review provides a re-search overview between miRNAs and pancreatic carcinoma .Meanwhile , the significance of Expression Profile in pancreatic carcinoma′s diagnosis ,treatment and prognosis is also discussed .